RHIT Exam Prep Practice Questions (Coding)
MCC stands for - ANSWER:Major complication and comorbitity
Medicare outpatients are grouped by: - ANSWER:APC
A coding professional may assume a cause-and-effect relationship between hypertension and which of
the following complications? - ANSWER:Hypertension and chronic kidney disease
When multiple burns are present, the first sequenced diagnosis is the: - ANSWER:Highest-degree burn
Nonessential modifiers are enclosed in: - ANSWER:Parentheses
The practice of undercoding can affect a hospital's MS-DRG case mix b/c It makes it lower than -
ANSWER:warranted by the actual service/resource intensity of the facility.
Medicare inpatient reimbursement levels are based on: - ANSWER:MS-DRG calculated for the encounter
NCCI edits prevent improper payments where - ANSWER:Incorrect code combinations are on the claim
Diagnosis-related groups are organized into: - ANSWER:MDC: Major diagnostic categories
_____ is a prospective payment system implemented by CMS in 1983 for payment of inpatient services
as a way to control Medicare spending. It reimburses hospitals a predetermined amount for each
medicare InPt stay. Payments are determined by the _____ to which each case is assigned according to
the patient's principal Dx. - ANSWER:DRG
CPT code determination for a malignant lesion excision is determined by... - ANSWER:-The body area
from which the excision occurs
- Diameter of the lesion as well as the margins excised as described in the OPERATIVE report.
According to CPT, a repair of a laceration that includes retention sutures would be considered what type
of closure? - ANSWER:Complex
A _____ repair of a wound goes beyond layer closure and requires scar revision, debridement, extensive
undermining, stents, or retention sutures. - ANSWER:Complex
_____ are not coded when they are integral to the disease process. Consider: Fever, nausea, influenza -
ANSWER:Signs and symptoms
The practice of using a code that results in a higher payment to the provider than the code that actually
reflects the service or item provided is known as: - ANSWER:Upcoding
_____ is designated and defined as the condition established after study to chiefly responsible for
occasioning the admission of the patient to the hospital for care. - ANSWER:Principal diagnosis
The _____ is assigned first with a category V10 code (Hx of cancer) used as an additional Dx -
ANSWER:Secondary Site Code (metastatic)
MCC stands for - ANSWER:Major complication and comorbitity
Medicare outpatients are grouped by: - ANSWER:APC
A coding professional may assume a cause-and-effect relationship between hypertension and which of
the following complications? - ANSWER:Hypertension and chronic kidney disease
When multiple burns are present, the first sequenced diagnosis is the: - ANSWER:Highest-degree burn
Nonessential modifiers are enclosed in: - ANSWER:Parentheses
The practice of undercoding can affect a hospital's MS-DRG case mix b/c It makes it lower than -
ANSWER:warranted by the actual service/resource intensity of the facility.
Medicare inpatient reimbursement levels are based on: - ANSWER:MS-DRG calculated for the encounter
NCCI edits prevent improper payments where - ANSWER:Incorrect code combinations are on the claim
Diagnosis-related groups are organized into: - ANSWER:MDC: Major diagnostic categories
_____ is a prospective payment system implemented by CMS in 1983 for payment of inpatient services
as a way to control Medicare spending. It reimburses hospitals a predetermined amount for each
medicare InPt stay. Payments are determined by the _____ to which each case is assigned according to
the patient's principal Dx. - ANSWER:DRG
CPT code determination for a malignant lesion excision is determined by... - ANSWER:-The body area
from which the excision occurs
- Diameter of the lesion as well as the margins excised as described in the OPERATIVE report.
According to CPT, a repair of a laceration that includes retention sutures would be considered what type
of closure? - ANSWER:Complex
A _____ repair of a wound goes beyond layer closure and requires scar revision, debridement, extensive
undermining, stents, or retention sutures. - ANSWER:Complex
_____ are not coded when they are integral to the disease process. Consider: Fever, nausea, influenza -
ANSWER:Signs and symptoms
The practice of using a code that results in a higher payment to the provider than the code that actually
reflects the service or item provided is known as: - ANSWER:Upcoding
_____ is designated and defined as the condition established after study to chiefly responsible for
occasioning the admission of the patient to the hospital for care. - ANSWER:Principal diagnosis
The _____ is assigned first with a category V10 code (Hx of cancer) used as an additional Dx -
ANSWER:Secondary Site Code (metastatic)
